Abstract 261: Quality of Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest is Hampered by Interruptions in Chest Compressions — A Nationwide Prospective Study
Background: Quality of cardiopulmonary resuscitation (CPR) is a critical determinant of outcome following out-of-hospital cardiac arrest. The aim of our study was to evaluate the quality of CPR provided by emergency medical service providers (Basic Life Support (BLS) capability) and emergency medical service providers assisted by paramedics, nurse anesthetists or physician-manned ambulances (Advanced Cardiac Life Support (ACLS) capability) in a nationwide, unselected cohort of out-of-hospital cardiac arrest cases.
Methods and results: We conducted a prospective, observational study of out-of-hospital cardiac arrest with non-traumatic etiology (> 18 years of age) occurring from the 1st to the 31st of January 2009 and treated by the primary Danish emergency medical service operator, covering approximately 85 % of the population. One hundred and ninety-one cases were eligible for analysis. Follow-up was up to one year or death. Quality of CPR was evaluated using measurements of transthoracic impedance. The majority of patients were treated by ambulances with ACLS capability (54 %). Interruptions in CPR related to loading of the patient into the emergency medical service vehicle were substantial, but independent of whether patients were managed by ACLS or BLS capable units (222 versus 224 seconds, P = 0.76) as were duration of interruptions during rhythm analysis alone (20 versus 22 seconds, P = 0.33) and defibrillation (24 versus 26 seconds, P = 0.07).
Conclusions: Nationwide, routine monitoring of transthoracic impedance is feasible. CPR is hampered by extended interruptions, particularly during loading of the patient into the emergency medical service vehicle, rhythm analysis and defibrillation.
- © 2010 by American Heart Association, Inc.